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Treatment

In 2011, a landmark clinical trial showed that early initiation of anti-retroviral therapy (ART) for people who are HIV-infected cuts the risk of HIV transmission by a stunning 96 percent. The trial provided powerful new momentum to global efforts to expand treatment access — both for the health of individuals living with HIV and for the potential to prevent millions of new infections.

Getting people onto treatment, though, is only half the story. To save lives and slow the HIV epidemic, treatment needs to achieve long-term virologic suppression — meaning the level of HIV in a person’s body is essentially undetectable. In most countries, only a minority of people with HIV have their virus in check. To make viral suppression the norm, better adherence programs, viral load monitoring and other steps are urgently needed.

Two studies published on Wednesday in the New England Journal of Medicine showed the effects of the monthly, long-acting injectable forms of cabotegravir and rilpivirine (Edurant). One study compared the injectable combination to standard oral therapy in people with HIV who were already virally suppressed. The other study compared the efficacy of the two drugs in injectable form to that of oral therapy for patients who were treatment-naive at the start of the study.

The ANRS TasP trial did not—and could not—demonstrate a reduction in HIV incidence, because the offer of UTT in the intervention communities did not increase ART coverage and population viral suppression compared to the standard of care in the control communities.

At the threshold of 2020, it’s clear that global goals for HIV prevention will miss the mark by a long shot. Though important progress has been made, the crisis UNAIDS called out in 2016 persists today with new infections around 1.7 million annually, a far cry from the 2020 target of fewer than 500,000. So, we asked ourselves, Now What?, and answered with cross-cutting analysis and an advocacy agenda to match.

On the Blog

AVAC released Now What?, our 2019 annual report on the state of the HIV prevention field. Each year, the AVAC Report frames the most pressing advocacy issues facing the HIV response. At the threshold of 2020, it’s clear that global goals for HIV prevention will miss the mark by a long shot.

The Resource Tracking for HIV Prevention R&D Working Group has launched its 15th annual report, HIV Prevention Research & Development Investments: Investing to end the epidemic, detailing overall 2018 investment and analysis of funding trends. And the Cure Resource Tracking Group has also released its annual report, Global Investment in HIV Cure Research and Development in 2018.